Jwara Part 2: Immunity in Ayurveda
“ It is to be observed, sir, that the persons taking wholesome food are both diseased and healthy and similarly in the case of unwholesome food. So how can good and bad effects be attributed to diet?” 1
As we are considering the topic of infectious diseases (Jwara), we will take some time to look at immunity as presented within Ayurveda. As we are all well aware, in any given epidemic, such as during flu season, some people will be affected while others will not. We would all like to be among the unaffected and better still, would like to support our patients being among the unaffected. Yet the question asked by Agnivesh, quoted above, points out the complexity of understanding resistance to disease.
In modern biomedicine, immunity is defined as “the ability of an organism to resist disease, either through the activities of specialized blood cells or antibodies produced by them in response to natural exposure or inoculation (active immunity) or by the injection of antiserum or the transfer of antibodies from a mother to her baby via the placenta or breast milk (passive immunity).”2 The immune system involves both humoral and cell-mediated immunity. Humoral immunity deals with infectious agents in the blood and lymph, (rasa and rakta dhatus) and is the usual way of dealing with viral and bacterial infections. It first involves phagocytosis of the foreign matter (antigen) by macrophages. The macrophage displays components of the foreign matter on its surface and this is soon detected by helper T-cells. These cells issue the “call to arms,” causing B cells to multiply rapidly. Some become plasma cells, manufacturing antibodies, while others become memory cells. The memory cells are the reason why we do not usually get the same infection twice, as they remember how to make antibodies to that specific antigen. CMI or cell-mediated immunity deals with infected cells and involves killer T-cells. The killer T-cells destroy the infected cells and also produce memory cells. This type of immunity is employed with larger pathogens such as parasites, fungi and protozoons.
In Ayurveda, immunity is known as vyadhikshamatva.3 There is a significant difference in how Ayurveda and modern biomedicine see immunity, or perhaps we should say, immunity and vyadhikshamatva are rather different concepts. As we have just seen above, one can be immune only to a specific disease and only by previously contracting the disease, having antibodies passively transferred to you (for short-term immunity only) or by immunization. Vyadhikshamatva, on the other hand, refers to a general ability to resist disease. This is in accord with Ayurveda’s view that many infectious diseases involve a conjunction of internal (nija) and external (aguntu) factors. For such diseases, the external agent is only a part of the causation; internal factors provide the ground in which the seed of the infection may or may not sprout. However, some extremely virulent infections undergo achaya prakop, that is to say, the dosha becomes provoked by the drastic external agent even without having already reached the stage of accumulation.
“Vyadhikshamatva implies a resistance against the loss of integrity, proportion and interrelationship” amongst the doshas and dhatus.3 So vyadhikshamatva rests upon equilibrium of dhoshas, dhatus, agnis and srotansi. This is swasthi, wellbeing, the goal of Ayurvedic preventative care.
Samadosha Samagnischa Samadhatu Malakriyah
Prasannatmendriya Manaha swastha Ityabhidhiyate.
“Having a balanced state of doshas, agni (digestive fire), dhatus (tissues) normal functioning of mala (waste products), cheerful state of atman (soul), sensory organs and mind are the symptoms of healthy life.” Not only physiological balance but also a positive, calm and cheerful state of mind helps provide resistance to disease. Right diet and lifestyle, proper use of the senses and positive qualities such as generosity, truthfulness and patience lead to arogya, the disease-free state.5
Vyadhikshamatva depends upon bala and ojas. “Bala imparts firm integrity to the muscles…strong voice, good complexion, and proper functions of the organs of sense and action.”6 Bala is of three types, sahaja, kalaja and yuktikrita.3 Sahaja bala is our innate strength inherited from our parents. Kalaja bala is strength in relation to time. Early morning, spring and youth provide maximum bala while evening, summer and old age offer weaker bala. Bala is also deteriorated at the change of seasons. In this context it is worth noting that an infant’s immune system is at its weakest at the age of six months, when passive immunity from the mother is waning and active immunity is yet to be acquired. Yuktikrita bala is the one that is in our own hands. We cannot change our genetics, nor alter our age, but we can attend to diet, exercise and rasayana herbs to enhance yuktikrita bala. One might speculate that yuktikrita bala operates on the level of epigenetics, shutting off gene expression for an array of illnesses.
Bala is increased by factors such as birth in a place having strong persons, such as the Hunza, birth at a favourable time, good attributes of sperm, ova and intrauterine environment, good diet, habits and state of mind, good physique, youth and a good exercise program.7
Ojas, bala and sleshma (kapha) are so closely related that some even regard them as synonymous.8 Ojas is a vital substance, expansible and pervading the entire body. In its absence the individual wanes and dies.8 According to Bhela Samhita, the main sites of ojas are twelve:8
- Shonita (Blood)
- Mamsa (Muscles)
- Meda (Fat)
- Asthi (bone)
- Majja (marrow and CNS)
- Shukra (reproductive tissue)
- Shukla (Body fluids)
- Sweda (sweat)
- Mutra (Urine)
- Purisha (stool)
Ojas is built from the nutrients absorbed in food, as honey is made from the nectar of various flowers.9 Ojas is soma-like in its cool, liquid properties, oily, white, stable, flowing, vivikta (pure), slimy, sweet, and prasana (bestowing cheerfulness.)10 It has the smell of fried paddy and the taste of honey and is the essence of all dhatus.8 Its health depends upon good jatar agni (digestive fire) and good dhatu agni of all seven dhatus.
To build vyadhikshamatva, we begin with the quality of sperm, ovum and uterus. By performing pancha karma and rasyana before conception, the parents can assure the finest quality of ovum, sperm and uterine lining. A conscious conception invoked by prayer and chanting supports the health of the child conceived. Next, the mother should observe the proper regimen during pregnancy. Classically, specific herbs are given for each month of pregnancy. Many of these herbs such as lotus and blue lotus are unavailable due to sustainability concerns. However, we can still support pregnancy with herbs such as vidari and licorice (small amounts of licorice) and with nourishing foods such as organic milk.
Administration of a tiny amount of honey and ghee from the first day of life is one of the key Ayurvedic strategies for building vyadhikshamatva in the neonate—however, the Americna Pediatric Association advises against giving honey to babies because of the danger of botulism. Classically, the honey and ghee was mixed with gold bhasma for maximum immunity. Durva (Bermuda grass) was given as an electuary (syrup). Even if we cannot follow all these measures today, we can do healing copper pyramid fires (agnihotra and om tryambakam homa) in a room adjacent to the baby’s room, and can continue this practice throughout childhood to build vyadhikshamatva according to ancient Vedic tradition.11
To support vyadhikshamatva throughout life, we need to care for ojas by caring for agni and build yuktikrita bala through right diet, right lifestyle, a positive attitude, a good exercise regimen and use of rasayana herbs. As old age approaches with its attendant loss of bala, it is vital to continue with exercise. Ashwagandha, haritaki and guggulu compunds for Vata, shatavari, amlaki chyavanprash and guduchi for pitta and punarnava, pippali and shilajit for kapha, along with judicious use of ghee, honey, milk and almonds help support bala and ojas into old age in the context of a good diet and lifestyle and a positive, cheerful state of mind.
As we have seen in this article, the basic measures used for preventative care in Ayurveda support vyadhikshamatva, helping our patients resist diseases of all kinds. With the inclusion of rasayana herbs and anupans, these measures may even affect epigenetics, shutting off gene expression for an array of diseases. A different concept than disease-specific immunity, vyadhikshamatva is our capacity to sustain health and resist disease and is supported by all measures that cultivate agni, bala and ojas.
- Charak, su xxviii 6
- Singh K, Verma B, The concept of vyadhikshamatva (immunity) in Ayurveda Int J Ayur Alli Sci., Vol.1, No.5 (2012) Pages 99 – 108
- Susruta, su. xv 45
- Charak, sha, ii 46
- Susruta, su, xv 25
- Charak, sha vi 13.
- Gehlot s, Singh BM< Concept of ojas; A scientific overview Anvikshili vol 2 num 3 2010
- Charak su xxviii 4
- Sushrut su xv 21